Insomnia as a predictor of high-lethality suicide attempts

Authors

  • M. Pompili,

    Corresponding author
    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
    • Correspondence to:

      Maurizio Pompili, M.D., Ph.D.,

      Department of Neurosciences,

      Mental Health and Sensory Organs, Suicide Prevention Center,

      Sant'Andrea Hospital, Sapienza University of Rome,

      1035-1039, Via di Grottarossa, 00189, Rome, Italy

      Tel.: + 390633775675

      Fax: + 390633775342

      Email: maurizio.pompili@uniroma1.it

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  • M. Innamorati,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • A. Forte,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • L. Longo,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • C. Mazzetta,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • D. Erbuto,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • F. Ricci,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • M. Palermo,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • H. Stefani,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • M. E. Seretti,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • D. A. Lamis,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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  • G. Perna,

    1. Department of Clinical Neurosciences, Villa San Benedetto – Hermanas Hospitalarias, Albese con Cassano, Como Lake, Italy
    2. Department of Psychiatry and Behavioral Sciences, Leonard Miller School of Medicine, University of Miami, Coral Gables, FL, USA
    3. Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
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  • G. Serafini,

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • M. Amore,

    1. Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
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  • P. Girardi

    1. Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • Disclosure

    There are no known conflicts of interest associated with this publication and there has been no significant financial support for this work that could have influenced its outcome.

Summary

Introduction

Research has demonstrated that patients with insomnia are at an increased risk of experiencing suicidal ideation and/or making a suicide attempt.

Objectives

To evaluate the relation between insomnia and suicidal behaviour.

Aims

To examine factors associated with a diagnosis of insomnia in patients admitted to an Emergency Department (ED) and assessed by the psychiatrist in charge.

Methods

Participants were 843 patients consecutively admitted to the ED of Sant'Andrea Hospital in Rome, between January 2010 and December 2011. All patients admitted were referred to a psychiatrist. A clinical interview based on the Mini International Neuropsychiatric Interview (MINI) and a semi-structured interview was conducted. Patients were asked about ‘ongoing’ suicidal ideation or plans for suicide.

Results

Forty-eight percent of patients received a diagnosis of bipolar disorder (BD), major depressive disorder (MDD) or an anxiety disorder; whereas, 17.1% were diagnosed with Schizophrenia or other non-affective psychosis. Patients with insomnia (compared to patients without insomnia) more frequently had a diagnosis of BD (23.9% vs. 12.4%) or MDD (13.3% vs. 9.5%; p < 0.001). Moreover, patients with insomnia less frequently had attempted suicide in the past 24 h (5.3% vs. 9.5%; p < 0.05) as compared with other patients, but those patients with insomnia who attempted suicide more frequently used a violent method (64.3% vs. 23.6%; p < 0.01) compared to other suicide attempters.

Conclusions

Our results do not support an association between insomnia and suicidal behaviour. However, suicide attempters with insomnia more frequently used violent methods, and this phenomenon should be taken into serious consideration by clinicians.

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